Radiation Induced Tumor After Stereotactic Radiosurgery for an Arteriovenous Malformation: A Case Report.
OBJECTIVE: To present a rare case of a radiation-induced malignancy after stereotactic radiosurgery.
CLINICAL PRESENTATION: A 34-year-old woman presented with headaches. Imaging studies demonstrated a 4.5-cm arteriovenous malformation located in the pineal region. She was treated with a two-isocenter plan to a total dose of 1500 cGy prescribed to the 70% isodose line. She was lost to follow-up and presented with a change in mental status, nausea, headaches, and a generalized seizure 9 years later. Magnetic resonance imaging scans demonstrated a large, heterogeneously enhancing mass partially in the treatment volume.
INTERVENTION: Surgical debulking demonstrated an infiltrating glial neoplasm consistent with a glioblastoma multiforme. There was no staining for epidermal growth factor receptor, whereas greater than 75% of nuclei stained positively with p53.
CONCLUSION: The risk of radiation-induced tumors is currently unknown but needs to be determined to assess the risk-benefit profile for each patient.
Published In/Presented At
Berman, E. L., Eade, T N., Brown, D. F., Weaver, M. Glass, J. Zorman, G. Feigenberg, S. J., (2007). Radiation Induced Tumor After Stereotactic Radiosurgery for an Arteriovenous Malformation: A Case Report. Neurosurgery, 61(5), E1099 doi: 10.1227/01.neu.0000303207.92617.4e
Medical Pathology | Pathology
Department of Pathology and Laboratory Medicine, Pathology Laboratory Medicine Faculty